AB0585 COMORBIDITY CLUSTERS AND THEIR RELATIONSHIP WITH SEVERITY AND OUTCOMES OF THE INDEX DISEASES, IN A LARGE MULTICENTER SYSTEMIC LUPUS ERYTHEMATOSUS COHORT (RELESSER REGISTER)
Authors: I. Rua-Figueroa, N. Pérez-Veiga, M. Galindo-Izquierdo, E. Rodríguez Almaraz, M. C. Erausquin, A. Fernandez-Nebro, E. Uriarte Isacelaya, B. Serrano-Benavente, J. Calvo, S. Manrique Arija, J. M. Senabre-Gallego, J. A. Bernal, J. Narváez, E. Tomero Muriel, E. Aurrecoechea, M. Ibañez Barceló, V. Torrente Segarra, C. Sanguesa, M. Freire González, M. J. Garcia Villanueva, M. Arévalo, C. Moriano, C. L. Iñíguez, A. Pérez Gómez, J. L. Andréu Sánchez, T. Cobo-Ibáñez, L. Horcada, G. Bonilla, N. Lozano Rivas, R. Blanco, L. Expósito, C. A. Montilla-Morales, F. J. Toyos Sáenz de Miera, O. Ibarguengoitia, E. Valls-Pascual, F. J. Nóvoa Medina, E. Salgado Perez, T. C. Salman Monte, R. Menor-Almagro, J. A. Román Ivorra, A. Muñoz Jimenez, J. M. Pego-Reigosa
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Patients with Systemic lupus erythematosus (SLE) have a well-known increased risk of major comorbidities, but they are also very heterogeneous in term of prevalence of comorbid conditions. The relationship of the comorbidities with the outcomes and the severity of index disease is less known. <h3>Objectives</h3> Evaluate the interactions between comorbid conditions, on a large multicenter SLE cohort from RELESSER register, and its impact in severity and outcomes. <h3>Methods</h3> Data about 14 cumulative comorbidities, as previously defined [1], where derived from patients with SLE (ACR-97 criteria) included in the retrospective phase of RELESSER. Severity Katz Index (SKI) and SLICC/ACR Damage Index (SDI) were calculated. An unsupervised cluster analysis using K-means method was implemented to define clusters. ANOVA and Tukey tests were used to compare continuous numerical variables; Kruskal-Wallis test to discrete variables and the Chi-square test (or Fisher's exact test) to categorical ones. <h3>Results</h3> A total of 3658 SLE patients (ACR-97 criteria) were included. Median SKI: 2 (interquartile range (IQR):1-3); median SDI:1(IQR:0-2). Demographic data are shown in Table 1. The comorbidities considered and their prevalence were: Thyroiditis (8.3%), peptic ulcer (3.8%), severe hepatopathy (1.0%), obstructive pulmonary disease (2.7%), Diabetes (5.0%), cardiovascular event (CVE) (11.0%), cardiac arrhythmia (4.2%), pulmonary embolism (3.4%), dementia (0.7%), malignancy (5.9%); serious infection (19.3%), end stage renal disease (2.8%), osteoporosis (7.3%) and depression (17.1%). Four cluster, with markedly different comorbidity profiles and outcomes were identified (table 3): one subgroup was clustered around depression (100% of the cases) (cluster 2), another cluster (cluster 3) with &gt; 1 serious infection (100%) and cluster 4, with 100% of CVE. In cluster 1, no patient had any of the 3 defining comorbidities in the rest of the clusters. There were no statistically significant differences between clusters in death by SLE. The clusters are characterized in more detail in table 1, where a just summary of the main comorbidities included in the analysis is displayed. <h3>Conclusion</h3> Cluster analysis identifies well-differentiated subgroups of SLE patients as regard comorbidities and associated mortality and severity of the disease. <h3>Reference</h3> [1]Rúa-Figueroa I et al. National registry of patients with systemic lupus erythematosus of the Spanish Society of Rheumatology: objectives and methodology. Reumatol Clin 2014;10(1):17-24. <h3>Acknowledgements</h3> Research Unit of the Spanish Society of Rheumatology. Spanish Foundation of. Rheumatology financial supporting, through the research intensification grants program. GSK financial. supporting, <h3>Disclosure of Interests</h3> None Declared.